| Entity Name: | CFAGI, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Sep 2016 (8 years ago) |
| Document Number: | M16000007737 |
| FEI/EIN Number | 81-4001387 |
| Address: | 14201 Dallas Pkwy, Dallas, TX, 75254, US |
| Mail Address: | 740 Concourse Parkway South, Suite 200, Maitland, FL, 32751, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467901520 | 2016-09-29 | 2023-02-22 | 401 COMMERCE ST, SUITE 600, NASHVILLE, TN, 372192446, US | 740 SOUTH CONCOURSE PARKWAY, SUITE 200, MAITLAND, FL, 32751, US | |||||||||||||||||||
|
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| Phone | +1 407-644-4014 |
Authorized person
| Name | CAROL CRUMP |
| Role | PRESIDENT, BOARD OF MANAGERS |
| Phone | 6157606588 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019722701 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT Corporation System | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Sims Karen | Auth | 14201 Dallas Pkwy, Dallas, TX, 75254 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000046322 | CENTER FOR ADVANCED GASTROENTEROLOGY | ACTIVE | 2024-04-04 | 2029-12-31 | No data | 601 11TH AVE N SUITE 800, NASHVILLE, TN, 37203 |
| G18000050985 | CENTER FOR ADVANCED GASTROENTEROLOGY | EXPIRED | 2018-04-23 | 2023-12-31 | No data | 401 COMMERCE STREET, SUITE 600, NASHVILLE, TN, 37219 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-15 | 14201 Dallas Pkwy, Dallas, TX 75254 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-15 | 14201 Dallas Pkwy, Dallas, TX 75254 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-15 | CT Corporation System | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-15 |
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-03-26 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-02-15 |
| Foreign Limited | 2016-09-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
